Spinning the doctors (and nurses)

When I worked in the NT Anti-Discrimination Commission a few years ago, one of the earliest lessons I learned was that there are always at least 3 stories in any situation: the applicant’s story, the respondent’s version, and the truth. I could embark on a reverie about multiple truths, the inevitable subjectivity of truth and so on, but that’s not where I want to take this post.

Last week’s Nine network Sunday program cover story, concerning revelations about alleged avoidable deaths in hospitals in south-west Sydney, provided an object lesson in the slippery nature of truth. According to the Sunday program, 18 of the 19 “avoidable” deaths that radio talkback empress Alan Jones’ “whistleblower” nurses revealed late last year had in fact already been detected and investigated by the internal review teams at the hospitals in question. Moreover, the 2 hospitals targetted by Jones in lurid tabloid “shock-horror” terms (Campbelltown and Camden) had records that were certainly no worse than other Sydney hospitals, and in some respects significantly better. The same was true of the Macarthur Health Service as a whole, and yet NSW Labor Health Minister Morris Iemma unhesitatingly sacked its CEO Jennifer Collins, apparently largely at the behest of Alan Jones.

The careers of other hospital administrators and clinicians remain under threat, despite the fact that Jones’ whistleblowers’ own behaviour and motivations seem suspect to say the least. One of Jones’ prime whistleblowers was even a member of her hospital’s Critical Care Committee. Yet she had never raised any of her alleged concerns about avoidable deaths with that Committee, and seldom bothered attending its meetings. Minister Iemma is apparently considering “compensating” Jones’ whistleblowers, even though none has lost her job or suffered any other measurable form of discrimination. In fact arguably it’s the dedicated hospital nurses, doctors and administrators of Campbelltown and Camden who deserve to be compensated, for the trauma and damage to their careers and reputations perpetrated by Jones and his elected minions Iemma and Carr.

Of course, it’s always possible that Sunday’s coverage of the issue is just as biased and inadequate as Alan Jones’ manifestly ignorant pompous bullying. Even if that turns out to be the case, the unfolding of this story highlights the extent to which populist governments in a mass media age are captive of powerful media opinion leaders, especially when those governments are led by cynical media-savvy demagogues like Bob Carr or John Howard.

Australian governments in the 21st century exhibit a parody of public accountability, responding in a cynical, ad hoc fashion only when pressured by influential talkback “gurus” or the Murdoch tabloid press. The public sector is hopelessly politicised and senior public servants are now invariably employed on insecure private contract terms, which make it impossible for them to provide, fearless, impartial advice to ministers. Wholesale corporatisation and privatisation of the public sector is also inimical to transparency and meaningful public accountability, as is the parallel implementation of private sector-derived “managerialist” techniques emphasising “productivity” and “outcomes” over both fairness and openness. The increasing willingness of bureaucrats, and even defence and intelligence agencies, to avoid telling politicians things they don’t want to hear is a direct manifestation of the decline of public accountability. That phenomenon was evident in the “children overboard” affair of 2001, and may well be a key factor in the still-emerging story of the intelligence analyses of Iraq’s WOMD capabilities.

Instead of submitting themselves and their administrations to effective public accountability mechanisms, leaders like Carr and Howard convey to voters an empty semblance of accountability by ostentatiously responding to the demands of pompous pundits like Jones, however unfair and unreasonable those demands may be. It gets them re-elected, but it’s the antithesis of good government. The demise of NSW Police Commissioner Peter Ryan at the behest of Jones and a couple of equally tawdry “whistleblowers” was every bit as disturbing as Iemma and Carr’s handling of the Macarthur Health Service “crisis” and the sacking of Jennifer Collins.

I wonder why the Sunday program’s revelations of two days ago have so far hardly caused a ripple on the public consciousness. The ABC website records a typically meaningless response from Bob Carr yesterday, but otherwise the story seems to have sunk without trace. Not even other bloggers have picked it up, as far as I can see. Do any Sydney-based readers know of other recent developments on this story? It raises a range of important issues deserving much more careful attention than they’ve so far received IMO.

About Ken Parish

Ken Parish is a legal academic, with research areas in public law (constitutional and administrative law), civil procedure and teaching & learning theory and practice. He has been a legal academic for almost 20 years. Before that he ran a legal practice in Darwin for 15 years and was a Member of the NT Legislative Assembly for almost 4 years in the early 1990s.
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David Tiley
2022 years ago

“Australian governments.. capabilities” is a terrific one para summary of something evil. And the Sunday transcript left me feeling sick, because it is part of the same process of politicisation. One of the most precious factors in good government is the ability to offer advice which changes the bureaucratic consensus to incoporate reality, even down at the most basic program level as I know from front line arts program management.

Geoff Honnor
Geoff Honnor
2022 years ago

ABC Radio in Sydney ran with it for a day, featuring the Critical Care Committee Whistleblower’s predictable if implausible claim that the Minutes had been ‘doctored’ and her concerns “not recorded” therein.

The completely uncritical media and political beatification of “Whistleblowers” in the health sector and elsewhere is a phenomenon of the age. Look at Andrew Wilkie. Jones was certainly blathering away but EVERY media outlet – without exception – bought the Macarthur Whistleblower case, uncritically. No-one ever examined the nurses’ motivation or the context of their involvement with – and relationship to – the problems at Camden and Campbelltown. They were, simply, “right.” One of them was raving on about a “conspiracy” involving the Nurses Association in the early days, which gives a pretty clear indication of the case for a more investigative approach. The nurse who claimed she’d been “bullied” by Craig Knowles had her claims refuted by other people who were present but, to no avail.

The Health system is a huge, unwieldy, infinitely complex labyrinth of conflicting agendas, enormously powerful, entrenched stakeholders and, crucially, the point at which human mortality and ever increasing – often unrealistic – expectation of same, comes into constant play. Virtually nothing is as it seems and no area of human endeavour is more subject to inherently subjective
assessment.

For instance, “the Nursing crisis” is actually a crisis within nursing. Nursing, as a profession, no longer wishes to nurse. They wish to be health co-partners with docs – and certainly in no way subject to medical direction. This is a fact known to everyone in the health system but doesn’t seem to register outside it where nurses are still benevolently viewed as the brow-smoothing angels of the nursing profession’s own worst nightmares.

On nights at Camden and Campbelltown there were basically young resident docs, a couple of Registrars maybe – the huge traditional teaching hospitals in the south-east and central AH services still soak up the trainee specialists – and nary a specialist to be seen until the dawn’s early light and even then, the nearest large repository of them would be at Westmead, several kilometres away.

The Colleges still restrict specialist entry with Stalinist rigidity, the AMA and the Commonwealth do a constant balancing act on Medicare provider numbers and Nursing continues to insist that every nurse must aspire to a Ph.D. Caught in the middle are “health adminstrators” hated and blamed by everyone else for attempting to “manage” – no matter how timid and ineffectual their efforts.

Then we have the politicians. Craig Knowles was the best health minister NSW has had in a while, but none of them actually “manage health” they simply preside over it, attempting to plug leaks, polish the brasses and keep stakeholders and the punters relatively onside – as far as that’s possible, which isn’t very far.

Dave Ricardo
Dave Ricardo
2022 years ago

“Nursing, as a profession, no longer wishes to nurse. They wish to be health co-partners with docs – and certainly in no way subject to medical direction”

The rot set in when nursing became an object of study at university. Why anyone needs to learn “poststructural theory of bedpans”, I will never know.

I long for the good old days, when the head nurse was known for having dirt on her knees.

observa
observa
2022 years ago

Ditto and we may well ask what political party, has become captive to what particular education sector, that has been responsible for this outrageous, start-up qualifications creep in nursing. The femocrats(my sister & co)have been responsible for this.

The pollies and pundits should also be careful about demonising the medical profession down to the level of the banking sector.

Homer Paxton
Homer Paxton
2022 years ago

Dave,
My Dad was a nurse and he readily concurs with your view.

Imposing ‘degree qualifiactions’ upon positions where it clearly is not needed is credentialism at its worst.

I think one of the problems is imposing private sector ideas on a public sector service.

It is absurd in the extreme for a Hospital Administrator, and I have know a few, to keep beds empty merely to get the budget ‘back on track’.

Jim
Jim
2022 years ago

Ken,
Great post!
I couldn’t agree more – the debasement of responsible government and rational,democratic debate by “fast food” type journalism is disturbing to say the least.
But what’s the answer?
We can’t silence Jones and the other pied pipers without taking the road to censorship. If we look to the legal system (defamation/libel laws)we find a media already protesting the existing laws and very unlikely to support further regulation.
The Murdoch,Fairfax,Packer and ABC networks all have their own line to push and don’t stray much from it.
Is education the solution?
Can we teach children to be healthily sceptical but not cynical?
BTW – re the culture of modern nursing;having worked in the aged care sector for 8 years or so the best line I ever heard about the culture of “modern nursing” came from a Ricardo Semmler enthusiast and consultant I met 5 years ago. After addressing a group of nurses about team work and quality benchmarking he told that he’d never met a group of people who ,when asked to define their role,virtuously produced a list of what they wouldn’t do;I’m a nurse which means I won’t empty bed pans,I won’t make beds,I won’t fill water jugs etc etc.
That said it all for me!

Gummo Trotsky
2022 years ago

It’s a pity Iemma didn’t think to sling Jones a couple of million to provide favourable on-air comment on the issue.

Gibbo
2022 years ago

Ken,
I am really glad to see you take this up. It is a subject that I have commented on at my site this week and there will be lots more to follow after another dose of crap in our local papers.
This can’t be allowed to just fall of the face earth.

Gibbo
2022 years ago

Ken,
I am really glad to see you take this up. It is a subject that I have commented on at my site this week and there will be lots more to follow after another dose of crap in our local papers.
This can’t be allowed to just fall of the face earth.

Gibbo
2022 years ago

Ken,
I am really glad to see you take this up. It is a subject that I have commented on at my site this week and there will be lots more to follow after another dose of crap in our local papers.
This can’t be allowed to just fall of the face earth.

David Tiley
2022 years ago

Gibbo, ironically, is showing us just how determined he is to take this up… :)

Gibbo
2022 years ago

Ooops!
Sorry for the multiple posts folks.
Maybe you are right David. This thing has really gotten under my skin. All being well I will have some more to say about it today.
Thaks for your interest.
Cheers, Gibbo.

Karen
Karen
2022 years ago

Sadly, the Sunday story was just as big a load of nonsense as the Alan Jones version. Jones bent over backwards to “prove” the whistleblower nurses were revealing a pattern of deaths and corruption reaching to the highest levels of government, including broadcasting demonstrably false claims like the knowles “bullying” thing.

Sunday’s Ross Coulthart then bent over backwards to “prove” the nurses were liars and frauds and the government was corrupt for responding to their claims.

Demonstrably silly statements on Sunday included Coultharts claim that Camden/Campbelltown hospitals were fine because Canterbury Hospital had a higher death rate then they did. True, but as the Health Dept pointed out, Canterbury Hospital has Sydney’s largest palliative care unit, where the very old and frail spend the last few weeks of their lives. The high death rate is no reflection on the hospital and cannot be compared to places like Camden which have NO palliative care facilities.

Of course, Ross Coulthart knew this perfectly well but he’s as big a charlatan as Jones is.

The reality is somewhere in the middle of Coultharts and Jones’ tabloid rantings — there clearly were serious problems in the administration of these hospitals (eg. poorly kept patient records, chaotic rostering and a lack of doctors willing to attend the hospital). On the other hand, the claims of mass deaths are foolish — hospitals are by definition full of sick people, and medicine is not an exact science. Sometimes, doctors and nurses misdiagnose or fail to spot warning signs. Sometimes, even with the best and most accurate care, patients die.

Of course, a story with right on both sides is too boring for media outlets to report. Much better to create a cast of villians and heroes and run the story as if its a Harry Potter novel and not real life, mm?